Is intraosseous vascular access associated with poorer patient outcomes than intravenous access after out-of-hospital cardiac arrest? In a secondary analysis, published in Annals of Emergency Medicine , researchers reviewed the encounters of 13,155 patients for nontraumatic out-of-hospital cardiac arrest (OHCA) from the Resuscitation Outcomes Consortium Prehospital Using an Impedance Valve and Early Versus Delayed (PRIMED) study.
Researchers identified whether patients had intravenous (IV) or intraosseous (IO) access. The primary outcome was favorable neurologic outcome on hospital discharge, defined as a modified Rankin score of 3 or less. Secondary outcomes were the return of spontaneous circulation and survival to hospital discharge. Researchers analyzed the data for different variables and used logistic regression to account for them, including age, sex, initial emergency medical services, shockable or nonshockable rhythm, witnessed or not-witnessed arrests, and others.
Of the encounters included in the study, 660 patients had IO access and 12,495 had IV access. Patients were separated on the basis of which route of access was initially started. They were excluded if they had any unsuccessful attempts at IO or IV access, if they had both IO and IV access, or if they had no access at all. The original PRIMED dataset excluded pregnant and incarcerated patients, those with do-not-resuscitate orders or with severe burns, and those thought to have suffered from exsanguination.
